Provider Demographics
NPI:1649876921
Name:PARKER, BLYTHE DANICA (LM)
Entity type:Individual
Prefix:
First Name:BLYTHE
Middle Name:DANICA
Last Name:PARKER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 JOURNEYS END WAY
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-5600
Mailing Address - Country:US
Mailing Address - Phone:360-298-2429
Mailing Address - Fax:833-699-4677
Practice Address - Street 1:455 JOURNEYS END WAY
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-5600
Practice Address - Country:US
Practice Address - Phone:360-298-2429
Practice Address - Fax:833-699-4677
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61109023176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife